Patients with advanced melanoma treated with ipilimumab may be able to survive up to 10 years, according to the results of a study presented at the 2013 European Cancer Congress (ECC). These patients experienced an overall survival plateau that started at 3 years and extended through to at least 10 years.
“These results are important to healthcare providers and patients with advanced melanoma since they provide a perspective on long-term survival for ipilimumab patients who are alive after 3 years of treatment,” study author Stephen Hodi, MD, assistant professor of medicine at the Dana-Farber Cancer Institute said in a press release. “Our data, which represent the longest follow-up of the largest numbers of patients on any globally approved melanoma therapy, will provide a benchmark for future medicines for advanced melanoma.”
Prior research had shown that a percentage of patients assigned to ipilimumab for melanoma experienced long-term survival. In this study, Hodi and colleagues sought to further define long-term survival. To do this they pooled patient survival data from 1,861 patients treated with ipilimumab across 12 studies of the drug. Their primary endpoint was overall survival, which they defined as the time from randomization or first dose date until death.
The median overall survival of the patients was 11.4 months; 254 (22%) patients survived at least 3 years. Twenty-six percent of patients who were treatment naive and 20% of previously treated patients survived to 3 years.
“The plateau, which started at three years and continued through to 10 years was observed regardless of dose, whether the patients had received previous treatment or not, and whether or not they had been kept on a maintenance dose of the drug,” Hodi said. “However, as this was not a randomized comparison, one cannot draw direct conclusions on differences between the doses or the populations.”
The researchers conducted a secondary analysis with an additional 2,985 patients for a total of 4,846 patients. This cohort included patients with ECOG performance status of 2, brain metastases, and noncutaneous primaries. The median overall survival in this group was 9.5 months and 21% of patients experienced an overall survival plateau at 3 years.
Commenting on the results, Alexander Eggermont, MD, past president of the European Cancer Organisation (ECCO) said, “With a response rate of only 10% to 15%, one can achieve more than 3 to 10 years survival in 17% to 25% of patients who have received only a few doses of ipilimumab. Thus, patients apparently can keep residual tumors under control for a long time when the immune system is properly ‘reset,’ and the concept of “clinical cures’ becomes a reality.”